Research Summary

Acoramidis Linked to Fewer Heart Failure Events in ATTR-CM

Ashton L. Stahl

Key Highlights

  • Heart failure–specific events occurred in 48.8% of acoramidis recipients versus 67.3% of placebo recipients at 30 months.
  • Acoramidis was associated with a 45% lower risk of a first heart failure–specific event, with an effect observed within the first month.
  • Continuous acoramidis was associated with lower heart failure mortality through 54 months compared with switching from placebo to acoramidis.

An exploratory analysis of ATTRibute-CM found that acoramidis was associated with fewer heart failure (HF)–specific events in patients with transthyretin amyloid cardiomyopathy (ATTR-CM), according to an abstract being presented at the American Heart Association Scientific Sessions 2026 on November 8.

The analysis examined HF mortality, hospitalization, and outpatient worsening HF. According to the abstract, HF-related events accounted for approximately two-thirds of cardiovascular deaths and hospitalizations in ATTRibute-CM, but an efficacy analysis focused specifically on HF events had not previously been reported.

ATTRibute-CM participants were randomized 2:1 to acoramidis hydrochloride 800 mg or placebo twice daily for 30 months. Participants were subsequently invited to receive acoramidis in an ongoing open-label extension. This post hoc analysis included the modified intention-to-treat population: 409 acoramidis recipients and 202 placebo recipients.

Researchers assessed the first HF-specific event, defined as HF mortality, HF hospitalization lasting at least 24 hours or an urgent HF visit lasting less than 24 hours, or outpatient worsening HF. Analyses accounted for non-HF deaths as competing events. Cox proportional hazards models evaluated first-event risk across participant subgroups through 30 months and HF mortality through 54 months.

Study Findings

At 30 months, 48.8% of participants receiving acoramidis experienced an HF-specific event, compared with 67.3% receiving placebo. The reported number needed to treat was 6. Acoramidis was associated with a 45% reduction in first-event risk versus placebo (hazard ratio [HR], 0.55; 95% CI, 0.44–0.69; P < .001), with an effect observed within the first month.

Treatment effects were directionally consistent across prespecified subgroups, including New York Heart Association classes and N-terminal pro–B-type natriuretic peptide concentrations. Acoramidis was associated with lower event rates across all HF event types. Through 54 months, continuous acoramidis was associated with lower HF mortality than initial placebo followed by acoramidis during the extension (HR, 0.42; 95% CI, 0.27–0.65; P < .001).

Clinical Implications

According to the study authors, the exploratory findings demonstrate acoramidis efficacy in reducing HF-specific events, including HF mortality, hospitalizations, and outpatient worsening HF. The authors described HF-specific events as clinically relevant manifestations of ATTR-CM progression affecting morbidity, healthcare utilization, and quality of life. They also reported directionally consistent treatment effects across participant subgroups.

Expert Commentary

“Continuous acoramidis was associated with a durable reduction in HF mortality through 54 months,” the researchers concluded.

Reference

Hanna M, Skaarup KG, Lam CSP, et al. Effects of acoramidis on heart failure events in transthyretin amyloid cardiomyopathy: results from ATTRibute-CM. Abstract Su1037. Presented at: American Heart Association Scientific Sessions 2026; November 8, 2026.